Pediatric obstructive sleep apnea: current management

Abstract

Obstructive sleep apnea syndrome (OSAS) is a condition frequently encountered in children, and belongs to a spectrum of diseases called sleep-disordered breathing. Its pathophysiology is related to decreased ventilation despite respiratory effort, leading to episodes of hypopnea and apnea. Left untreated, this condition could have a significant impact on both physical and mental health. Primary snoring is often the presenting symptom reported by parents, and should warrant careful screening for OSAS. Although overnight polysomnography remains the gold standard diagnostic test for OSAS, its feasibility in clinical practice is less obvious, and furthermore, interpretation of its results is not unanimously agreed on. This is why in clinical practice history and physical examination remain among the most useful diagnostic tools. Management of OSAS traditionally includes tonsillectomy and/or adenoidectomy to which most of the cases respond. However, other risk factors and coexisting conditions should be carefully investigated and treated prior to considering surgical treatment.